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Healt Guıde

What is obesity?
Factors such as technological developments, fast nutrition with dry and high-calorie foods, inactivity, and false dietary practices stimulate obesity known as fatness that is one of the most common health problems in our day. In accordance with the obesity classification of the World Health Organization (WHO), Body Mass Index (BMI) has been used to diagnose obesity. According to the BMI results, the individuals with BMI>30 kg/m2 are called obese, the individuals with BMI>40 kg/m2 are called morbid obese, and the individuals with >50 kg/m2 are called super obese. Morbid obesity is a serious disease that obstructs even the major physical activities and causes various physical and psychological disorders. The most important way to stop the rapid increase of obesity is to prevent the individuals from the risk of obesity.

Psychological Aspect of Obesity
As the patient gains weight, s/he begins to isolate herself/himself from social life. Her/his self-confidence and interest decrease, and s/he begins to dislike herself/himself. Failure of any weight loss attempt seriously impairs the patient’s self-confidence. Due to such reasons, almost 50% of the patients has been diagnosed clinically with depression. Therefore, psychological treatment should not be ignored when the physical treatment is initiated for obesity.

“The primary treatment methods of obesity are diet and increased physical activity’’
As a chronic disease, obesity covers a serious process that requires a multidisciplinary approach at all levels of the treatment.
- Medical nutrition (diet) treatment
Dietary plan must be made only for the relevant patient in the treatment of obesity. Aim of the nutrition treatment is to decrease the amount of fat deposits of the body by creating an energy gap. Amount of the fat deposits should be decreased without any loss in muscles and vital organs, and loss of vitamin, mineral and electrolyte should be prevented.
- Physical Activity
The patient must be examined in terms of cardiac and respiratory diseases before starting her/his physical activities. A patient with morbid obesity should begin her/his physical activities with simple exercises and increase them gradually. In addition to exercises that will be made regularly, the patient should avoid from the use of any vehicle for the places within walking distance, get off the bus one stop early, prefer to use the stairs rather than the elevator, and park her/his car further away from her/his work, home etc.
- Medical Treatment
Drugs used for treatment of obesity in our day can be listed as follows:
Drugs that prevent the breakdown and absorption of nutrients, drugs that affect and function on hormones, and drugs that function as appetite suppressants
- Surgical Procedures for Obesity
Surgical intervention is an ideal treatment option for the individuals who cannot achieve any success through diet, exercise and medical treatment or regain the weights lost in a short time. Successful results can be achieved by applying the proper surgical method that will be decided considering the patient’s characteristics and accompanying diseases. The common criteria, that have been approved by many national and international institutions such as the World Health Organization to determine the individuals who will be treated by surgical procedures, are as follows:
- Obese patients with BMI ≥40 kg/m2
- Patients with accompanying diseases and BMI between 35 and 40 kg/m2
- Patients with BMI between 30 and 35 kg/m2, whose glucose regulation cannot be
provided sufficiently despite insulin treatment, and who have type II diabetes with accompanying diseases

Methods Used in Surgical Procedures for Treatment of Obesity
The methods used in surgical procedures for treatment of obesity are divided into three groups:
1. Restrictive methods: These are surgical procedures that reduce the volume of the stomach by removing or closing a part of it with sutures (for instance, sleeve gastrectomy – tube stomach) or slow down the passage of food through a part of the stomach by applying a pressure to the stomach with the help of an adjustable gastric band.
2. Methods that accelerate the passage of food: These are surgical procedures that are effective in bypassing the first meters of the intestines where the nutrients are mixed with the digestive fluids, broken down and absorbed.
3. These are surgical procedures that are combined with the restrictive methods and the methods that accelerate the passage of food (such as Roux-n-Y gastric bypass, mini-gastric bypass)